Currently, in the United States, perforations of the eye wall (i.e., punctures through the entire wall) are closed using sutures. Sutures are placed through the layers of the eye wall tissue at the apposed margins of the perforation. The margins are drawn together and held closed with knots. Typically resorbable sutures are used, and therefore the suture knots may be exposed on the ocular wall surface for an extended period of time. Sutures leave high profile knots on the exterior surface of the eye. These knots can be felt by the patient and cause discomfort, which is known to lead to eye-rubbing and subsequent infection.
Outside of the U.S., certain bioadhesives are approved for use in the eye. For example, cyanoacrylate and fibrin glue are approved for use in Europe to close scleral and/or corneal perforations. These methods are currently not approved in the United States. Moreover, fibrin glue consists of genetically stripped fibrinogen and thrombin extracted from human or animal (e.g. bovine) blood. While this material is effective and biocompatible, fibrin glues carry a risk of viral and other pathogen transmission. Cyanoacrylate (e.g crazy glue) polymerizes in high modulus, rigid aggregates. The resulting solidified adhesive is very granular and often can feel like sand in the eye. This again can lead to discomfort and eye rubbing, which can cascade into irritation and infection. There is some evidence that unpolymerized cyanoacrylate may have some neurotoxic effects.
As noted above, both of the foregoing approaches have associated drawbacks. Provided herein are thermo-responsive polymers, hydrogel compositions, methods and devices which overcome many of the shortcomings of currently available materials and approaches for treating ocular trauma, especially under conditions requiring rapid and effective temporary treatment of ocular wounds.